The continuous mutation and rapid spread of the severe acute respiratory syndrome coronavirus 2(SARSCoV-2)have led to the ineffectiveness of many antiviral drugs targeting the original strain.To keep pace with the vi...The continuous mutation and rapid spread of the severe acute respiratory syndrome coronavirus 2(SARSCoV-2)have led to the ineffectiveness of many antiviral drugs targeting the original strain.To keep pace with the virus’evolutionary speed,there is a crucial need for the development of rapid,cost-effective,and efficient inhibitor screening methods.In this study,we created a novel approach based on fluorescence resonance energy transfer(FRET)technology for in vitro detection of inhibitors targeting the interaction between the SARS-CoV-2 spike protein RBD(s-RBD)and the virus receptor angiotensin-converting enzyme 2(ACE2).Utilizing crystallographic insights into the s-RBD/ACE2 interaction,we modified ACE2 by fusing SNAP tag to its N-terminus(resulting in SA740)and Halo tag to s-RBD’s C-terminus(producing R525H and R541H),thereby ensuring the proximity(<10 nm)of labeled FRET dyes.We found that relative to the R541H fusion protein,R525H exhibited higher FRET efficiency,which attributed to the shortened distance between FRET dyes due to the truncation of s-RBD.Utilizing the sensitive FRET effect between SA740 and R525H,we evaluated its efficacy in detecting inhibitors of SARS-CoV-2 entry in solution and live cells.Ultimately,this FRET-based detection method was demonstrated high sensitivity,rapidity,and simplicity in solution and held promise for high-throughput screening of SARS-CoV-2 inhibitors.展开更多
Background: Sorafenib and sunitinib are widely used as first-line targeted therapy for metastatic renal cell carcinoma(mRCC) in China.This study aimed to compare the efficacy, safety, and quality of life(QoL) in Chine...Background: Sorafenib and sunitinib are widely used as first-line targeted therapy for metastatic renal cell carcinoma(mRCC) in China.This study aimed to compare the efficacy, safety, and quality of life(QoL) in Chinese mRCC patients treated with sorafenib and sunitinib as first-line therapy.Methods: Clinical data of patients with mRCC who received sorafenib(400 mg twice daily; 4 weeks) or sunitinib(50 mg twice daily; on a schedule of 4 weeks on treatment followed by 2 weeks off) were retrieved. Primary outcomes were overall survival(OS), progression-free survival(PFS), adverse events(AEs), and QoL(SF-36 scores), and secondary outcomes were associations of clinical characteristics with QoL.Results: Medical records of 184 patients(110 in the sorafenib group and 74 in the sunitinib group) were reviewed.PFS and OS were comparable between the sorafenib and sunitinib groups(both P > 0.05).The occurrence rates of leukocytopenia, thrombocytopenia, and hypothyroidism were higher in the sunitinib group(36.5% vs. 10.9%,P< 0.001; 40.5% vs. 10.9%, P < 0.001; 17.6% vs. 3.6%, P = 0.001), and that of diarrhea was higher in the sorafenib group(62.7% vs. 35.2%, P < 0.001). There was no significant difference in SF-36 scores between the two groups. Multivariate analysis indicated that role-physical and bodily pain scores were associated with the occurrence rate of grade 3 or 4 AEs(P = 0.017 and 0.005).Conclusions: Sorafenib has comparable efficacy and lower toxicity profile than sunitinib as first-line therapy for mRCC. Both agents showed no significant impact on QoL of patients.展开更多
Background:Hypoalbuminemia adversely affects the clinical outcomes of various cancers.The purpose of this study was to estimate the prognostic value of hypoalbuminemia 3-5 weeks after treatment in patients with metast...Background:Hypoalbuminemia adversely affects the clinical outcomes of various cancers.The purpose of this study was to estimate the prognostic value of hypoalbuminemia 3-5 weeks after treatment in patients with metastatic renal cell carcinoma(mRCC) who received sorafenib or sunitinib as first-line treatment.Methods:In this single-center,retrospective study,we assessed the progression-free survival(PFS) and overall survival(OS) of 184 mRCC patients who received first-line sorafenib or sunitinib treatment.PFS and OS were compared between patients with post-treatment hypoalbuminemia(post-treatment albumin level <36.4 g/L) and those with normal post-treatment albumin level(albumin level≥36.4 g/L).The Memorial Sloan Kettering Cancer Center(MSKCC)risk model stratified mRCC patients into three risk categories.Prognostic values of all patient characteristics including MSKCC risk category were determined by using univariate and multivariate Cox regression models.Prognostic value was further determined using the Harrell concordance index and receiver operating characteristic curve analysis.Results:The median PFS and OS of the 184 patients were 11 months(95%confidence interval[CI]9-12 months)and 23 months(95%CI 19-33 months),respectively.Patients with post-treatment hypoalbuminemia had significantly shorter median PFS(6 months[95%CI 5-7 months]) and OS(11 months[95%CI 9-15 months]) than patients who had normal post-treatment albumin levels(PFS:12 months[95%CI 11-16 months],P < 0.001;OS:31 months[95%CI24-42 months],P < 0.001),respectively.Multivariate analysis showed that post-treatment hypoalbuminemia was an independent predictor of PFS(hazard ratio[HR],2.113;95%CI 1.390-3.212;P < 0.001) and OS(HR,2.388;95%CI 1.591-3.585;P < 0.001).Post-treatment hypoalbuminemia could also be combined with the MSKCC risk category for better prediction about OS.The model that included post-treatment hypoalbuminemia and MSKCC risk category improved the predictive accuracy for PFS and OS(c-index:0.68 and 0.73,respectively) compared with the basic MSKCC risk model(c-index:0.67 and 0.70,respectively).The prognostic values for PFS and OS of the integrated MSKCC risk model involving post-treatment hypoalbuminemia were significantly more accurate than the basic MSKCC risk model using likelihood ratio analysis(both P < 0.001).Conclusions:Post-treatment hypoalbuminemia can be considered an independent prognostic factor for patients with mRCC who undergo first-line treatment with tyrosine kinase inhibitors.Additionally,integrating post-treatment serum albumin level into the basic MSKCC risk model can improve the accuracy of this model in predicting patient overall survival and progression-free survival.展开更多
The use of the internal magnetic field of ferromagnets can effectively promote charge separation and transfer(CST)in photoelectrochemical energy conversion.However,photoelectrochemical materials with a ferromagnetic f...The use of the internal magnetic field of ferromagnets can effectively promote charge separation and transfer(CST)in photoelectrochemical energy conversion.However,photoelectrochemical materials with a ferromagnetic field are scarce,and the internal magnetic field is negligible in nonferromagnetic mate-rials.To address this issue,we propose a rational method for preparing ferromagnetic TiO_(2)powder using controllable oxygen vacancies in anatase TiO_(2)with co-exposed{001}and{101}facets.Accordingly,an ex-cellent saturation magnetisation of 0.0014 emu/g in TiO_(2)is achieved owing to an asymmetric and uneven charge distribution.Compared with that of nonferromagnetic TiO_(2),the efficiency of photocatalytic hydro-gen generation of ferromagnetic TiO_(2)is improved by 0.64 times.The enhancement of photocatalytic hy-drogen generation is due to the different forces exerted on the electrons and holes in the magnetic field,which significantly improve the photogenerated CST efficiency of ferromagnetic TiO_(2).This result high-lights the significant role of the synergistic regulation of the crystal structure and defects in regulating the ferromagnetic characteristics of materials.The findings of this study provide guidance for leveraging point defects to promote CST for high-efficiency solar-energy conversion systems.展开更多
Integrating nanowires with nonuniform diameter and random spatial distribution into an array can afford unconventional and additional means for modulating optical response.However,experimental realization of such a na...Integrating nanowires with nonuniform diameter and random spatial distribution into an array can afford unconventional and additional means for modulating optical response.However,experimental realization of such a nanowire array is quite challenging.In this work,we propose a new fabrication strategy which takes advantage of ion track technology,via sequential swift heavy ion irradiation and ion track etching.Based on this strategy,we unprecedentedly realize nanowire arrays,using gold as an example,with gradient and programmable diameters in a controlled manner.We further demonstrate that such nanowire arrays can support broadband,tunable,and enhanced plasmonic responses.We believe that our new type of nanowire arrays will find great potential in applications such as light management and optoelectronic devices.展开更多
BACKGROUND While Singapore attains good health outcomes,Singapore’s healthcare system is confronted with bed shortages and prolonged stays for elderly people recovering from surgery in acute hospitals.An Acute Hospit...BACKGROUND While Singapore attains good health outcomes,Singapore’s healthcare system is confronted with bed shortages and prolonged stays for elderly people recovering from surgery in acute hospitals.An Acute Hospital-Community Hospital(AHCH)care bundle has been developed to assist patients in postoperative rehabilitation.The core concept is to transfer patients out of AHs when clinically recommended and into CHs,where they can receive more beneficial dedicated care to aid in their recovery,while freeing up bed capacities in AHs.AIM To analyze the AH length of stay(LOS),costs,and savings associated with the AH-CH care bundle intervention initiated and implemented in elderly patients aged 75 years and above undergoing elective orthopedic surgery.METHODS A total of 8621:1 propensity score-matched patients aged 75 years and above who underwent elective orthopedic surgery in Singapore General Hospital(SGH)before(2017-2018)and after(2019-2021)the care bundle intervention period was analyzed.Outcome measures were AH LOS,CH LOS,hospitalization metrics,postoperative 30-d mortality,and modified Barthel Index(MBI)scores.The costs of AH inpatient hospital stay in the matched cohorts were compared using cost data in Singapore dollars.RESULTS Of the 862 matched elderly patients undergoing elective orthopedic surgery before and after the care bundle intervention,the age distribution,sex,American Society of Anesthesiologists classification,Charlson Comorbidity Index,and surgical approach were comparable between both groups.Patients transferred to CHs after the surgery had a shorter median AH LOS(7 d vs 9 d,P<0.001).The mean total AH inpatient cost per patient was 14.9%less for the elderly group transferred to CHs(S$24497.3 vs S$28772.8,P<0.001).The overall AH U-turn rates for elderly patients within the care bundle were low,with a 0%mortality rate following orthopedic surgery.When elderly patients were discharged from CHs,their MBI scores increased significantly(50.9 vs 71.9,P<0.001).CONCLUSION The AH-CH care bundle initiated and implemented in the Department of Orthopedic Surgery appears to be effective and cost-saving for SGH.Our results indicate that transitioning care between acute and community hospitals using this care bundle effectively reduces AH LOS in elderly patients receiving orthopedic surgery.Collaboration between acute and community care providers can assist in closing the care delivery gap and enhancing service quality.展开更多
In order to enhance the fatigue properties of metallic materials,a feasible rationale is to delay or prevent the interior and surface fatigue crack initiation.Based on this rationale,the study investigates the approac...In order to enhance the fatigue properties of metallic materials,a feasible rationale is to delay or prevent the interior and surface fatigue crack initiation.Based on this rationale,the study investigates the approach of improving the very high cycle fatigue properties of TC6 titanium alloys through near-βforging coupled with shot peening,conducted at 930℃and ambient temperature,respectively.To unveil the associated mechanisms,microstructure,microhardness,residual stress,and fatigue properties are thoroughly analyzed after each process.Results indicate a considerable refinement in microstructure and significant mitigation of the initially existed strong texture post near-βforging and annealing,efficiently delaying crack initiation and propagation.As a result,the very high cycle fatigue property of TC6 achieves remarkable enhancement after forging.Compared to near-βforging,shot peening might not necessarily improve the very high cycle fatigue performance,particularly beyond 10^(6)cycles.展开更多
This study was conducted to investigate the effects of catechins on reproductive performance, antioxidative capacity and immune function of gestating sows. A total of 60 cross-bred（Landrace × Large White） multi...This study was conducted to investigate the effects of catechins on reproductive performance, antioxidative capacity and immune function of gestating sows. A total of 60 cross-bred（Landrace × Large White） multiparious sows were blocked by body weight, parity and backfact and randomly allocated to 1 of 5 treatments: 0.100,200,300, or 400 mg/kg catechins. Dietary treatments were imposed from mating to d 40 of gestation of sows. At farrowing, litter total born, born alive, dead, and normal-（healthy piglets,>0.85 kg） and low-birth weight piglets（<0.85 kg） were recorded. Within 3.00 ± 0.50 days after farrowing litter size was standardized to 8,00 ± 1.50 piglets within treatment. The piglets were weighed at birth（d 1） and weaning（d 28）. Sows serum samples were obtained from blood samples collected on d 40 of gestation for analyses of glutathione peroxidase（GSH-Px）, superoxide dismutase（SOD）, catalase（CAT）,malondialdehyde（MDA）, hydrogen peroxide（H2 O2）, nitric oxide synthetase（NOS） and nitrogen monoxide（NO）. Our results showed that supplementation of catechins at levels of 200 or 300 mg/kg led to improvements in litter born alive（P < 0.01） and piglet born healthy（P < 0.01） and a decrease in stillborn（P < 0.05） at farrowing when compared with the control. In comparison with the control, catechins at any supplemental levels all enhanced the serum SOD（P < 0.05） and CAT（P < 0.01） activities of sows at farrowing but no obvious differences in the serum GSH-Px and NOS activities were observed in this trial（P > 0.05）. Sows received 200 mg catechin per kg diets showed a reduction（P < 0.05） of the serum MDA level at farrowing compared with all other treatments. Sows received all the levels of catechin showed a reduction（P < 0.05） of serum H2 O2 level compared with sows received the control diet on both d 40 of gestation and farrowing. Our results demonstrated that the catechins may be a potential antioxidant to increase the reproductive performance and antioxidative capacity of sows when it was added into diets during the early gestation.展开更多
Dear editor,Renal cancer accounts for approximately 2%of all can-cer deaths worldwide,and renal cell carcinoma(RCC)is the predominant subtype[1].Radiotherapy and chemo-therapy have been found to have limited roles in ...Dear editor,Renal cancer accounts for approximately 2%of all can-cer deaths worldwide,and renal cell carcinoma(RCC)is the predominant subtype[1].Radiotherapy and chemo-therapy have been found to have limited roles in the treatment of RCC.However,the treatment outcomes of metastatic RCC(mRCC)have been improved drastically since the application of molecular targeted therapeutic agents such as tyrosine kinase inhibitors(TKIs).TKIs have been gradually used for the preoperative treatment of RCC.展开更多
In the immersive flow visualization based on virtual reality,how to meet the needs of complex professional flow visualization analysis by natural human–computer interaction is a pressing problem.In order to achieve t...In the immersive flow visualization based on virtual reality,how to meet the needs of complex professional flow visualization analysis by natural human–computer interaction is a pressing problem.In order to achieve the natural and efficient human–computer interaction,we analyze the interaction requirements of flow visualization and study the characteristics of four human–computer interaction channels:hand,head,eye and voice.We give out some multimodal interaction design suggestions and then propose three multimodal interaction methods:head&hand,head&hand&eye and head&hand&eye&voice.The freedom of gestures,the stability of the head,the convenience of eyes and the rapid retrieval of voices are used to improve the accuracy and efficiency of interaction.The interaction load is balanced by multimodal interaction to reduce fatigue.The evaluation shows that our multimodal interaction has higher accuracy,faster time efficiency and much lower fatigue than the traditional joystick interaction.展开更多
A novel approach to visually represent meteorological data has emerged with the maturation of Immersive Analytics(IA).We have proposed an immersive meteorological virtual sandbox as a solution to the limitations of 2D...A novel approach to visually represent meteorological data has emerged with the maturation of Immersive Analytics(IA).We have proposed an immersive meteorological virtual sandbox as a solution to the limitations of 2D analysis in expressing and perceiving data.This innovative visual method enables users to interact directly with data through non-contact aerial gestures(NCAG).Referring to the“What you see is what you get”concept in scientific visualization,we proposed a novel approach for the visual exploration of meteorological data that aims to immerse users in the analysis process.We hope this approach can inspire immersive visualization techniques for other types of geographic data as well.Finally,we conducted a user questionnaire to evaluate our system and work.The evaluation results demonstrate that our system effectively reduces cognitive burden,alleviates mental workload,and enhances users’retention of analysis findings.展开更多
基金supported by the National Natural Science Foundation of China(Nos.22225806,22378385,22078314,22278394)Dalian Institute of Chemical Physics(Nos.DICPI202142,DICPI202436,DMU-1&DICP UN202301).
文摘The continuous mutation and rapid spread of the severe acute respiratory syndrome coronavirus 2(SARSCoV-2)have led to the ineffectiveness of many antiviral drugs targeting the original strain.To keep pace with the virus’evolutionary speed,there is a crucial need for the development of rapid,cost-effective,and efficient inhibitor screening methods.In this study,we created a novel approach based on fluorescence resonance energy transfer(FRET)technology for in vitro detection of inhibitors targeting the interaction between the SARS-CoV-2 spike protein RBD(s-RBD)and the virus receptor angiotensin-converting enzyme 2(ACE2).Utilizing crystallographic insights into the s-RBD/ACE2 interaction,we modified ACE2 by fusing SNAP tag to its N-terminus(resulting in SA740)and Halo tag to s-RBD’s C-terminus(producing R525H and R541H),thereby ensuring the proximity(<10 nm)of labeled FRET dyes.We found that relative to the R541H fusion protein,R525H exhibited higher FRET efficiency,which attributed to the shortened distance between FRET dyes due to the truncation of s-RBD.Utilizing the sensitive FRET effect between SA740 and R525H,we evaluated its efficacy in detecting inhibitors of SARS-CoV-2 entry in solution and live cells.Ultimately,this FRET-based detection method was demonstrated high sensitivity,rapidity,and simplicity in solution and held promise for high-throughput screening of SARS-CoV-2 inhibitors.
基金supported by the National Natural Science Foundation of China(Nos.81402084,81472378)the Shanghai Municipal Commission of Health and Family Planning(No.2013SY027)the Incubating Program for Clinical Research and Innovation of Renji Hospital(No.PYXJS16-008)
文摘Background: Sorafenib and sunitinib are widely used as first-line targeted therapy for metastatic renal cell carcinoma(mRCC) in China.This study aimed to compare the efficacy, safety, and quality of life(QoL) in Chinese mRCC patients treated with sorafenib and sunitinib as first-line therapy.Methods: Clinical data of patients with mRCC who received sorafenib(400 mg twice daily; 4 weeks) or sunitinib(50 mg twice daily; on a schedule of 4 weeks on treatment followed by 2 weeks off) were retrieved. Primary outcomes were overall survival(OS), progression-free survival(PFS), adverse events(AEs), and QoL(SF-36 scores), and secondary outcomes were associations of clinical characteristics with QoL.Results: Medical records of 184 patients(110 in the sorafenib group and 74 in the sunitinib group) were reviewed.PFS and OS were comparable between the sorafenib and sunitinib groups(both P > 0.05).The occurrence rates of leukocytopenia, thrombocytopenia, and hypothyroidism were higher in the sunitinib group(36.5% vs. 10.9%,P< 0.001; 40.5% vs. 10.9%, P < 0.001; 17.6% vs. 3.6%, P = 0.001), and that of diarrhea was higher in the sorafenib group(62.7% vs. 35.2%, P < 0.001). There was no significant difference in SF-36 scores between the two groups. Multivariate analysis indicated that role-physical and bodily pain scores were associated with the occurrence rate of grade 3 or 4 AEs(P = 0.017 and 0.005).Conclusions: Sorafenib has comparable efficacy and lower toxicity profile than sunitinib as first-line therapy for mRCC. Both agents showed no significant impact on QoL of patients.
基金supported by the National Natural Science Foundation of China(Grant Nos.81402084,81472378,and 81672513)incubating program for clinical research and innovation of Renji hospital(Grant No.PYXJS16-008)the Shanghai Municipal Commission of Health and Family Planning(Grant No.2013SY027)
文摘Background:Hypoalbuminemia adversely affects the clinical outcomes of various cancers.The purpose of this study was to estimate the prognostic value of hypoalbuminemia 3-5 weeks after treatment in patients with metastatic renal cell carcinoma(mRCC) who received sorafenib or sunitinib as first-line treatment.Methods:In this single-center,retrospective study,we assessed the progression-free survival(PFS) and overall survival(OS) of 184 mRCC patients who received first-line sorafenib or sunitinib treatment.PFS and OS were compared between patients with post-treatment hypoalbuminemia(post-treatment albumin level <36.4 g/L) and those with normal post-treatment albumin level(albumin level≥36.4 g/L).The Memorial Sloan Kettering Cancer Center(MSKCC)risk model stratified mRCC patients into three risk categories.Prognostic values of all patient characteristics including MSKCC risk category were determined by using univariate and multivariate Cox regression models.Prognostic value was further determined using the Harrell concordance index and receiver operating characteristic curve analysis.Results:The median PFS and OS of the 184 patients were 11 months(95%confidence interval[CI]9-12 months)and 23 months(95%CI 19-33 months),respectively.Patients with post-treatment hypoalbuminemia had significantly shorter median PFS(6 months[95%CI 5-7 months]) and OS(11 months[95%CI 9-15 months]) than patients who had normal post-treatment albumin levels(PFS:12 months[95%CI 11-16 months],P < 0.001;OS:31 months[95%CI24-42 months],P < 0.001),respectively.Multivariate analysis showed that post-treatment hypoalbuminemia was an independent predictor of PFS(hazard ratio[HR],2.113;95%CI 1.390-3.212;P < 0.001) and OS(HR,2.388;95%CI 1.591-3.585;P < 0.001).Post-treatment hypoalbuminemia could also be combined with the MSKCC risk category for better prediction about OS.The model that included post-treatment hypoalbuminemia and MSKCC risk category improved the predictive accuracy for PFS and OS(c-index:0.68 and 0.73,respectively) compared with the basic MSKCC risk model(c-index:0.67 and 0.70,respectively).The prognostic values for PFS and OS of the integrated MSKCC risk model involving post-treatment hypoalbuminemia were significantly more accurate than the basic MSKCC risk model using likelihood ratio analysis(both P < 0.001).Conclusions:Post-treatment hypoalbuminemia can be considered an independent prognostic factor for patients with mRCC who undergo first-line treatment with tyrosine kinase inhibitors.Additionally,integrating post-treatment serum albumin level into the basic MSKCC risk model can improve the accuracy of this model in predicting patient overall survival and progression-free survival.
基金the China Postdoctoral Science Foundation(Grant No.2021M701829)It was also sup-ported by the Natural Science Foundation of Gansu Province in China(Grant No.22JR5RA484)+2 种基金Fundamental Research Funds for the Central University(Nos.lzujbky-2021-61 and SWU-KT22001)State Key Laboratory of New Ceramic and Fine Processing Ts-inghua University(No.KF202118)The authors would like to thank Tsinghua-Deqing Joint Research center for Materials Design and Industrial Innovation for the support.The authors would like to thank Shiyanjia Lab(www.shiyanjia.com)for the support provided for hydrogen generation,SS-SPV measurement,ESR test,DFT cal-culations,and modification polish.
文摘The use of the internal magnetic field of ferromagnets can effectively promote charge separation and transfer(CST)in photoelectrochemical energy conversion.However,photoelectrochemical materials with a ferromagnetic field are scarce,and the internal magnetic field is negligible in nonferromagnetic mate-rials.To address this issue,we propose a rational method for preparing ferromagnetic TiO_(2)powder using controllable oxygen vacancies in anatase TiO_(2)with co-exposed{001}and{101}facets.Accordingly,an ex-cellent saturation magnetisation of 0.0014 emu/g in TiO_(2)is achieved owing to an asymmetric and uneven charge distribution.Compared with that of nonferromagnetic TiO_(2),the efficiency of photocatalytic hydro-gen generation of ferromagnetic TiO_(2)is improved by 0.64 times.The enhancement of photocatalytic hy-drogen generation is due to the different forces exerted on the electrons and holes in the magnetic field,which significantly improve the photogenerated CST efficiency of ferromagnetic TiO_(2).This result high-lights the significant role of the synergistic regulation of the crystal structure and defects in regulating the ferromagnetic characteristics of materials.The findings of this study provide guidance for leveraging point defects to promote CST for high-efficiency solar-energy conversion systems.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.U1932210,12005270,and 11975114).
文摘Integrating nanowires with nonuniform diameter and random spatial distribution into an array can afford unconventional and additional means for modulating optical response.However,experimental realization of such a nanowire array is quite challenging.In this work,we propose a new fabrication strategy which takes advantage of ion track technology,via sequential swift heavy ion irradiation and ion track etching.Based on this strategy,we unprecedentedly realize nanowire arrays,using gold as an example,with gradient and programmable diameters in a controlled manner.We further demonstrate that such nanowire arrays can support broadband,tunable,and enhanced plasmonic responses.We believe that our new type of nanowire arrays will find great potential in applications such as light management and optoelectronic devices.
文摘BACKGROUND While Singapore attains good health outcomes,Singapore’s healthcare system is confronted with bed shortages and prolonged stays for elderly people recovering from surgery in acute hospitals.An Acute Hospital-Community Hospital(AHCH)care bundle has been developed to assist patients in postoperative rehabilitation.The core concept is to transfer patients out of AHs when clinically recommended and into CHs,where they can receive more beneficial dedicated care to aid in their recovery,while freeing up bed capacities in AHs.AIM To analyze the AH length of stay(LOS),costs,and savings associated with the AH-CH care bundle intervention initiated and implemented in elderly patients aged 75 years and above undergoing elective orthopedic surgery.METHODS A total of 8621:1 propensity score-matched patients aged 75 years and above who underwent elective orthopedic surgery in Singapore General Hospital(SGH)before(2017-2018)and after(2019-2021)the care bundle intervention period was analyzed.Outcome measures were AH LOS,CH LOS,hospitalization metrics,postoperative 30-d mortality,and modified Barthel Index(MBI)scores.The costs of AH inpatient hospital stay in the matched cohorts were compared using cost data in Singapore dollars.RESULTS Of the 862 matched elderly patients undergoing elective orthopedic surgery before and after the care bundle intervention,the age distribution,sex,American Society of Anesthesiologists classification,Charlson Comorbidity Index,and surgical approach were comparable between both groups.Patients transferred to CHs after the surgery had a shorter median AH LOS(7 d vs 9 d,P<0.001).The mean total AH inpatient cost per patient was 14.9%less for the elderly group transferred to CHs(S$24497.3 vs S$28772.8,P<0.001).The overall AH U-turn rates for elderly patients within the care bundle were low,with a 0%mortality rate following orthopedic surgery.When elderly patients were discharged from CHs,their MBI scores increased significantly(50.9 vs 71.9,P<0.001).CONCLUSION The AH-CH care bundle initiated and implemented in the Department of Orthopedic Surgery appears to be effective and cost-saving for SGH.Our results indicate that transitioning care between acute and community hospitals using this care bundle effectively reduces AH LOS in elderly patients receiving orthopedic surgery.Collaboration between acute and community care providers can assist in closing the care delivery gap and enhancing service quality.
基金financial support from the National Science and Technology Major Project(Grant No.J2019-IV-0010-0078)the National Natural Science Foundation of China(Grant Nos.12172139 and 11972012)funding from the Fundamental Research Funds for the Central Universities(Grant No.2019kfyXJJS141).
文摘In order to enhance the fatigue properties of metallic materials,a feasible rationale is to delay or prevent the interior and surface fatigue crack initiation.Based on this rationale,the study investigates the approach of improving the very high cycle fatigue properties of TC6 titanium alloys through near-βforging coupled with shot peening,conducted at 930℃and ambient temperature,respectively.To unveil the associated mechanisms,microstructure,microhardness,residual stress,and fatigue properties are thoroughly analyzed after each process.Results indicate a considerable refinement in microstructure and significant mitigation of the initially existed strong texture post near-βforging and annealing,efficiently delaying crack initiation and propagation.As a result,the very high cycle fatigue property of TC6 achieves remarkable enhancement after forging.Compared to near-βforging,shot peening might not necessarily improve the very high cycle fatigue performance,particularly beyond 10^(6)cycles.
基金jointly supported by grants from the National Key Technology Research and Development Program of the Ministry of Science and Technology of China(2012BAD39B00)State Key Laboratory of Animal Nutrition(2004DA125184F1305)+2 种基金the NSFC(307005793110173031110103909)
文摘This study was conducted to investigate the effects of catechins on reproductive performance, antioxidative capacity and immune function of gestating sows. A total of 60 cross-bred（Landrace × Large White） multiparious sows were blocked by body weight, parity and backfact and randomly allocated to 1 of 5 treatments: 0.100,200,300, or 400 mg/kg catechins. Dietary treatments were imposed from mating to d 40 of gestation of sows. At farrowing, litter total born, born alive, dead, and normal-（healthy piglets,>0.85 kg） and low-birth weight piglets（<0.85 kg） were recorded. Within 3.00 ± 0.50 days after farrowing litter size was standardized to 8,00 ± 1.50 piglets within treatment. The piglets were weighed at birth（d 1） and weaning（d 28）. Sows serum samples were obtained from blood samples collected on d 40 of gestation for analyses of glutathione peroxidase（GSH-Px）, superoxide dismutase（SOD）, catalase（CAT）,malondialdehyde（MDA）, hydrogen peroxide（H2 O2）, nitric oxide synthetase（NOS） and nitrogen monoxide（NO）. Our results showed that supplementation of catechins at levels of 200 or 300 mg/kg led to improvements in litter born alive（P < 0.01） and piglet born healthy（P < 0.01） and a decrease in stillborn（P < 0.05） at farrowing when compared with the control. In comparison with the control, catechins at any supplemental levels all enhanced the serum SOD（P < 0.05） and CAT（P < 0.01） activities of sows at farrowing but no obvious differences in the serum GSH-Px and NOS activities were observed in this trial（P > 0.05）. Sows received 200 mg catechin per kg diets showed a reduction（P < 0.05） of the serum MDA level at farrowing compared with all other treatments. Sows received all the levels of catechin showed a reduction（P < 0.05） of serum H2 O2 level compared with sows received the control diet on both d 40 of gestation and farrowing. Our results demonstrated that the catechins may be a potential antioxidant to increase the reproductive performance and antioxidative capacity of sows when it was added into diets during the early gestation.
基金This study was supported by the research project of Shanghai Science and Technology Commission(18ZR1423200)the Incubating Program for Clinical Research and Innovation of Renji Hospital(PYXJS16-008)the Shen Kang 3-year action plan program(16CR3062B)
文摘Dear editor,Renal cancer accounts for approximately 2%of all can-cer deaths worldwide,and renal cell carcinoma(RCC)is the predominant subtype[1].Radiotherapy and chemo-therapy have been found to have limited roles in the treatment of RCC.However,the treatment outcomes of metastatic RCC(mRCC)have been improved drastically since the application of molecular targeted therapeutic agents such as tyrosine kinase inhibitors(TKIs).TKIs have been gradually used for the preoperative treatment of RCC.
基金supported in part by the National Natural Science Foundation of China(No.61872304,No.61802320)the State Key Laboratory of Aerodynamics(SKLA20200203)the National Numerical Windtunnel Project(NNW2019ZT6-A17).
文摘In the immersive flow visualization based on virtual reality,how to meet the needs of complex professional flow visualization analysis by natural human–computer interaction is a pressing problem.In order to achieve the natural and efficient human–computer interaction,we analyze the interaction requirements of flow visualization and study the characteristics of four human–computer interaction channels:hand,head,eye and voice.We give out some multimodal interaction design suggestions and then propose three multimodal interaction methods:head&hand,head&hand&eye and head&hand&eye&voice.The freedom of gestures,the stability of the head,the convenience of eyes and the rapid retrieval of voices are used to improve the accuracy and efficiency of interaction.The interaction load is balanced by multimodal interaction to reduce fatigue.The evaluation shows that our multimodal interaction has higher accuracy,faster time efficiency and much lower fatigue than the traditional joystick interaction.
基金supported by Natural Science Foundation of Sichuan Province(Grant No.2022NSFSC0961)the Ph.D.Research Foundation of Southwest University of Science and Technology(Grant No.19zx7144)the Special Research Foundation of China(Mianyang)Science and Technology City Network Emergency Management Research Center(Grant No.WLYJGL2023ZD04).
文摘A novel approach to visually represent meteorological data has emerged with the maturation of Immersive Analytics(IA).We have proposed an immersive meteorological virtual sandbox as a solution to the limitations of 2D analysis in expressing and perceiving data.This innovative visual method enables users to interact directly with data through non-contact aerial gestures(NCAG).Referring to the“What you see is what you get”concept in scientific visualization,we proposed a novel approach for the visual exploration of meteorological data that aims to immerse users in the analysis process.We hope this approach can inspire immersive visualization techniques for other types of geographic data as well.Finally,we conducted a user questionnaire to evaluate our system and work.The evaluation results demonstrate that our system effectively reduces cognitive burden,alleviates mental workload,and enhances users’retention of analysis findings.
